Prediction of response to medical therapy by serum soluble (pro)renin receptor levels in Graves' disease

PLoS One. 2018 Apr 5;13(4):e0195464. doi: 10.1371/journal.pone.0195464. eCollection 2018.

Abstract

Antithyroid drugs are generally selected as the first-line treatment for Graves' Disease (GD); however, the existence of patients showing resistance or severe side effects to these drugs is an important issue to be solved. The (pro)renin receptor [(P)RR] is a multi-functional protein that activates the tissue renin-angiotensin system and is an essential constituent of vacuolar H+-ATPase, necessary for the autophagy-lysosome pathway. (P)RR is cleaved to soluble (s)(P)RR, which reflects the status of (P)RR expression. In this retrospective study, we aimed to investigate whether serum s(P)RR concentration can be used as a biomarker to predict the outcome of antithyroid drug treatment in GD patients. Serum s(P)RR levels were measured in 54 untreated GD patients and 47 control participants. Effects of medical treatment with antithyroid drugs on these levels were investigated in GD patients. Serum s(P)RR levels were significantly higher in patients with Graves' disease than in control subjects (P<0.005) and were significantly reduced after medical treatment for Graves' disease. High serum s(P)RR levels were associated with resistance to antithyroid drug treatment, suggesting that serum s(P)RR concentration can be used as a useful biomarker to predict the outcome of antithyroid drug treatment in these patients. Patients with Graves' disease with low body mass index showed higher levels of serum soluble (pro)renin receptor levels than those with high body mass index. In addition, in patients with Graves' disease, serum triglyceride levels were negatively correlated with serum soluble (pro)renin receptor levels. All these data indicated an association between low nutrient condition due to hyperthyroidism and increased (pro)renin receptor expression in these patients, suggesting that (pro)renin receptor expression could be increased in the process of stimulating intracellular energy production via activating autophagy function to compensate energy loss.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antithyroid Agents / therapeutic use*
  • Biomarkers / blood
  • Body Mass Index
  • Female
  • Graves Disease / blood*
  • Graves Disease / drug therapy*
  • Humans
  • Hyperthyroidism / blood*
  • Male
  • Middle Aged
  • Receptors, Cell Surface / blood*
  • Renin-Angiotensin System / physiology
  • Retrospective Studies
  • Triglycerides / blood*
  • Vacuolar Proton-Translocating ATPases / blood*

Substances

  • ATP6AP2 protein, human
  • Antithyroid Agents
  • Biomarkers
  • Receptors, Cell Surface
  • Triglycerides
  • Vacuolar Proton-Translocating ATPases

Grants and funding

This work was supported by the Ministry of Education, Culture, Sports, Science and Technology of Japan (number 16K09657 to S.M. and 16H05316 to A.I.) and a grant from the Institute of Science of Blood Pressure and Hormone (to Y.M.).